Provider Demographics
NPI:1821108887
Name:SOILEAU, RALPH ANTHONY II (DDS)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ANTHONY
Last Name:SOILEAU
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1144 COOLIDGE BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-234-3551
Mailing Address - Fax:337-234-5389
Practice Address - Street 1:1144 COOLIDGE BLVD
Practice Address - Street 2:STE D
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-234-3551
Practice Address - Fax:337-234-5389
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist